Abstract
This study aimed to clarify the natural course of positional plagiocephaly using a three-dimensional (3D) scanner and investigate the effectiveness of cranial helmet therapy (CHT). One hundred infants with severe plagiocephaly who visited our institutions between April 2020 and March 2021 were included. Cranial shape was measured using an Artec Eva 3D scanner. A cranial asymmetry (CA) >12 mm was diagnosed as severe plagiocephaly. An infant whose CA subsided to <12 mm was considered to have improved naturally or by CHT. The difference in CA between the second and initial scans was defined as the improvement value (median scan interval was two months). In the natural-course group comprising 56 infants with severe plagiocephaly, 37 (66%) with a median CA of 15.6 mm exhibited no improvement after two months. In the scan age- and evaluation interval-matched case-control study, the CA value in the CHT group improved by three times that in the natural-course group (−4.6 mm [n = 33] vs. −1.55 mm [n = 24], p < 0.001). Severe plagiocephaly did not improve naturally in 66% of the cases. Therefore, CHT should be considered if the CA is >12 mm on the initial evaluation.
Highlights
Positional plagiocephaly is the most common type of cranial asymmetry in infants.The prevalence of plagiocephaly is age-dependent; it was 16.0%, 19.7%, 9.2%, 6.8%, and3.3% at 6 weeks and 4, 8, 12, and 24 months of age, respectively [1]
At the time of visiting the cranial-deformity outpatient department, the initiation of cranial helmet therapy (CHT) to correct the cranial shape is usually overdue for many infants, which is a current problem in clinical practice in Japan
Study 1: Obstetric factors, initial evaluation age, second evaluation age, evaluation interval, cranial asymmetry (CA), Cranial Vault Asymmetry Index (CVAI), their improvement value, head circumference, and growth of head circumference were investigated in the 56 infants with severe plagiocephaly following the natural course and subsequently compared between the no-change and improved groups
Summary
Positional plagiocephaly is the most common type of cranial asymmetry in infants.The prevalence of plagiocephaly is age-dependent; it was 16.0%, 19.7%, 9.2%, 6.8%, and3.3% at 6 weeks and 4, 8, 12, and 24 months of age, respectively [1]. Positional plagiocephaly is the most common type of cranial asymmetry in infants. In Japan, as infants are traditionally laid on their backs, plagiocephaly has commonly been observed and culturally accepted. Many pediatricians and gynecologists have generally provided assurance that the infants’ cranial shape would improve naturally [2,3]. The parents are usually instructed to observe the infants on medical checkups at 3–4 months or 6–7 months of age because plagiocephaly improves naturally. Many infants with plagiocephaly have been confirmed during medical checkups at 9–10 months and 1.5 years of age in Japan. At the time of visiting the cranial-deformity outpatient department, the initiation of cranial helmet therapy (CHT) to correct the cranial shape is usually overdue for many infants, which is a current problem in clinical practice in Japan
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